Pericarditi acute e ricorrenti in Pediatria

2021 ◽  
Vol 40 (7) ◽  
pp. 425-431
Author(s):  
Sara Della Paolera ◽  
Elena Favretto ◽  
Marco Bobbo ◽  
Egidio Barbi ◽  
Giulia Gortani
Keyword(s):  
Heart Disease ◽  
Chest Pain ◽  
Children And Adolescents ◽  
Clinical Management ◽  
Unknown Origin ◽  
Recurrent Pericarditis ◽  
Autoinflammatory Disorders ◽  
Common Cause ◽  
Paediatric Patients ◽  
First Choice

Chest pain in children and adolescents is rarely associated with an underlying heart disease. How-ever, when it does occur, pericarditis is the most common cause. Most cases are of unknown origin (idiopathic) and mild. Up to 15-35% of paediatric patients with idiopathic pericarditis experience a recurrence during their lives and clinical management in these cases may be challenging. NSAIDs are the first-choice drugs for the treatment of acute idiopathic pericarditis. Corticosteroids should be reserved for refractory pericarditis and autoimmune or autoinflammatory disorders with peri-cardial involvement. Colchicine plays a central role for the management of recurrent forms while anakinra has recently emerged as a remedy for colchicine-resistant and corticosteroid-dependent recurrent pericarditis.

Thrombin generation in paediatric patients with congenital heart disease

2008 ◽  
Vol 28 (S 01) ◽  
pp. S61-S66 ◽  
Author(s):  
G. Cvirn ◽  
A. Rosenkranz ◽  
B. Leschnik ◽  
W. Raith ◽  
W. Muntean ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Negative Correlation ◽  
Congenital Heart ◽  
Thrombin Generation ◽  
Significant Negative Correlation ◽  
Peak Height ◽  
Global Test ◽  
Paediatric Patients ◽  
Age Range

SummaryThrombin generation was studied in paediatric patients with congenital heart disease (CHD) undergoing cardiac surgery using the calibrated automated thrombography (CAT) in terms of the lag time until the onset of thrombin formation, time to thrombin peak maximum (TTP), endogenous thrombin potential (ETP), and thrombin peak height. The suitability to determine the coagulation status of these patients was investigated. Patients, material, methods: CAT data of 40 patients with CHD (age range from newborn to 18 years) were compared to data using standard coagulation parameters such as prothrombin (FII), antithrombin (AT), tissue factor pathway inhibitor (TFPI), prothrombin fragment 1.2 (F 1.2), thrombin-antithrombin (TAT), activated partial thromboplastin time (aPTT), and prothrombin time (PT). Results: A significant positive correlation was seen between ETP and FII (p < 0.01; r = 0.369), as well as between peak height and F II (p < 0.01; r = 0.483). A significant negative correlation was seen between ETP and TFPI values (p < 0.05; r = –0.225) while no significant correlation was seen between peak height and TFPI. A significant negative correlation was seen between F 1.2 generation and ETP (p < 0.05; r = –0.254) and between F 1.2 generation and peak height (p < 0.05; r = –0.236). No correlation was seen between AT and ETP or peak. Conclusions: CAT is a good global test reflecting procoagulatory and inhibitory factors of the haemostatic system in paediatric patients with CHD.

Pubertal status of children with congenital heart disease

2021 ◽  
pp. 1-5
Author(s):  
Zahra Ghaemmaghami ◽  
Zahra Khajali ◽  
Mohammad Dalili ◽  
Zahra Fotovati ◽  
Maryam Moradian ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Children And Adolescents ◽  
Congenital Heart ◽  
Normal Population ◽  
Large Sample Size ◽  
Pubertal Status ◽  
Major Aspect ◽  
Pubertal Onset ◽  
Pubertal Stages

Abstract Background: CHD influences many aspects of life in affected individuals. Puberty, a major aspect of development, is a concern for patients and families. Objectives: We investigated pubertal status in children and adolescents with CHD. Methods: Patients with CHD aged 6–18 were enrolled. Cardiac diagnoses were confirmed using history, examination, and paraclinical tools including echocardiography. An endocrinologist determined pubertal stages, and the second Tanner stages for pubarche (P2), thelarche (B2), and gonadarche (G2) were considered as the pubertal onset. A study with a large sample size on pubertal onset in a normal population was used for comparison. Results: Totally, 451 patients (228 girls and 223 boys) at a median (10th–90th percentile) age of 10.79 (8.02–14.28) years for the girls and 10.72 (8.05–14.03) years for the boys were enrolled. The median (10th–90th percentile) ages at B2 and P2 in the girls with CHD were 10.77 (9.55–12.68) and 10.53 (9.39–12.28) years, respectively, which were higher than the median ages of 9.74 (8.23–11.94) and 10.49 (8.86–12.17) years in the normal girls. The median (10th–90th percentile) ages at G2 and P2 in the boys with CHD were 11.04 (8.85–13.23) and 11.88 (9.78–13.46) years, correspondingly, which were higher than the median ages of 9.01 (6.00–11.84) and 10.34 (6.84–13.10) years in the normal boys. Conclusions: Pubertal onset could be delayed in children with CHD when compared with the normal population.

scholarly journals Acceptability of Outpatient Ready-To-Use Food-Based Protocols in HIV-Infected Senegalese Children and Adolescents Within the MAGGSEN Cohort Study

2016 ◽  
Vol 38 (1) ◽  
pp. 27-36 ◽  
Author(s):  
Cecile Cames ◽  
Marie Varloteaux ◽  
Ndeye Ngone Have ◽  
Alhadji Bassine Diom ◽  
Philippe Msellati ◽  
...  
Keyword(s):  
Cohort Study ◽  
Children And Adolescents ◽  
Clinical Management ◽  
Antiretroviral Treatment ◽  
Psychosocial Support ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Controlled Trials ◽  
Intervention Design ◽  
Moderate Acute Malnutrition

Objectives: To assess the acceptability of ready-to-use food (RUF)-based outpatient protocols in HIV-infected children and adolescents with severe acute malnutrition (SAM) and moderate acute malnutrition (MAM). Methods: Plumpy Nut and Plumpy Sup were supplied every 2 weeks and prescribed by weight to SAM and MAM children, respectively. Forty-three children, 24 MAM and 19 SAM, were enrolled. Organoleptic appreciation, feeding modalities, and perceptions surrounding RUF were recorded at week 2. Sachets were counted to measure adherence throughout the study. Results: Median age was 12.2 years (interquartile range: 9.3-14.8), and 91% were on antiretroviral treatment. Overall, 80%, 76%, 68%, and 68% of children initially rated RUF color, taste, smell, and mouth feeling as good. However, feelings of disgust, refusal to eat, fragmentation of intake, self-stigma, and sharing within the household were commonly reported. Eighteen MAM and 7 SAM experienced weight recovery. Recovery duration was 54 days (31-90) in MAM versus 114 days (69-151) in SAM children ( P = .02). Their rate of RUF consumption compared to amount prescribed was approximately 50% from week 2 to week 10. Nine failed to gain weight or consume RUF and were discontinued for clinical management, and 9 dropped out due to distance to the clinic. Conclusion: Initial RUF acceptability was satisfactory. More than half the children had successful weight recovery, although adherence to RUF prescription was suboptimal. However, further research is needed to propose therapeutic foods with improved palatability, alternative and simpler intervention design, and procedures for continuous and tailored psychosocial support in this vulnerable population. Trial registration: NCT01771562 (Current Controlled Trials).

scholarly journals Identification and prognostication of the substrate of ventricular arrhythmia with cardiac magnetic resonance (CMR) imaging in patients with normal echocardiography

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
S Younus ◽  
H Maqsood ◽  
A Gulraiz ◽  
MD Khan ◽  
R Awais
Keyword(s):  
Heart Disease ◽  
Ventricular Tachycardia ◽  
Cardiac Magnetic Resonance ◽  
Chest Pain ◽  
Magnetic Resonance ◽  
Ventricular Arrhythmia ◽  
Heart Diseases ◽  
Sustained Ventricular Tachycardia ◽  
Structural Heart Diseases ◽  
Cmr Imaging

Abstract Funding Acknowledgements Type of funding sources: Other. Main funding source(s): Self Introduction Malignant ventricular arrhythmia contributes to approximately half of the sudden cardiac deaths. In common practice, echocardiography is used to identify structural heart diseases that are the most frequent substrate of VA. Identification and prognostication of structural heart diseases are very important as they are the main determinant of poor prognosis of ventricular arrhythmia. Purpose : The objective of this study is to determine whether cardiac magnetic resonance (CMR) may identify structural heart disease (SHD) in patients with ventricular arrhythmia who had no pathology observed on echocardiography. Methods : A total of 864 consecutive patients were enrolled in this single-center prospective study with significant ventricular arrhythmia. VA was characterized as &gt;1000 ventricular ectopic beats per 24 hours, non-sustained ventricular arrhythmia, sustained ventricular arrhythmia, and no pathological lesion on echocardiography. The primary endpoint was the detection of SHD with CMR. Secondary endpoints were a composite of CMR detection of SHD and abnormal findings not specific for a definite SHD diagnosis. Results : CMR studies were used to diagnose SHD in 212 patients (24.5%) and abnormal findings not specific for a definite SHD diagnosis in 153 patients (17.7%). Myocarditis (n = 84) was the more frequent disease, followed by arrhythmogenic cardiomyopathy (n = 51), ischemic heart disease (n = 32), dilated cardiomyopathy (n = 17), hypertrophic cardiomyopathy (n = 12), congenital cardiac disease (n = 08), left ventricle noncompaction (n = 5), and pericarditis (n = 3). The strongest univariate and multivariate predictors of SHD on CMR images were chest pain (odds ratios [OR]: 2.5 and 2.33, respectively) and sustained ventricular tachycardia (ORs: 2.62 and 2.21, respectively). Conclusion : Our study concludes that SHD was able to be identified on CMR imaging in a significant number of patients with malignant VA and completely normal echocardiography. Chest pain and sustained ventricular tachycardia were the two strongest predictors of positive CMR imaging results. Abstract Figure. Distribution of different SHD

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